Objective To explore surgical management and biological characters of carotid body tumor (CBT). MethodsSixty-nine cases of CBT with 78 lesions were reviewed. The surgical approaches were: 1. Enucleation; 2. Resection along with the external carotid artery (CA); 3. En bloc resection with CA and restoration of CA with interpositional grafting or end-to-end anastomosis or external CA to internal CA anastomosis; 4. En bloc resection and restoration of CA using an improved method; 5. CBT resection and CA ligation at initial stage. Results The operative mortality was 3%. Postoperatively, hemiplegia occurred in one case. Horner syndrome, paralysis of glossopharyngeal and vagus, hypoglossal and ramus mandibulous of the facial nerve developed in 9, 9, 5 and 1 cases respectively. Fifty-six patients at follow-up of 1～18 (5) years were alive. Family occurrence (7%), bilateral growth (13%), trend of endocrine-secretion (2.6%), and malignant changes (10%) were found. Conclusion Five approaches were adopted for treating CBT preserving or restoring CA integrity. When CA is resected together with tumor and when the tumor is too close to cranial base, the distal internal CA can be isolated at the transverse cutting area, in which an end-to-end anastomosis can be established, and then the residual tumor can be resected leisurely.

Abnormalities of the inferior vena cava occur infrequently.Except a few patients,most with the abnormalities of the inferior vena cava have not symptoms and do not need surgical procedure.However,attentions should be pasd to these anomalies in operation,particularly in the retroperiwneal procedure.only when the anomalies are identified before operation,its pessible to avoid the disaster caused by side-damage.Understanding embryo development of the inferior vena cava is usdful to comprehend the generation mechanism and classification of abnormalities of the inferior vena cava and its main branches.Exact judgment to abnormalities of the inferior vens cava has the important clinical significance.

Objective To explore the surgical treatment of carotid body tumor(CBT). Methods The clinical data of 78 patients with CBT were retrospectively analysed. Results Seventy eight patients had 88 tumors (10 patients had bilateral CBT),of which 83 were resected. The operations included:CBT enucleation (28 tumors);CBT resection along with the external carotid artery resection(12 tumors); CBT enbloc resection with partial carotid artery(CA) resection and interposition grafting(3 tumors) or end to end anastomosis (1 tumor), and external to internal CA anastomosis (1 tumor); CBT enbloc resection with CA reconstruction(30 tumors), and CBT resection and CA ligation (8 tumors). The operative mortality was 3.8%(3/78). 65 tumors were followed up for 1～21 years,and one patient died of pulmonary metastasis seven years after the surgery. In the follow up period, 1 patient had a local recurrence two years after the surgery,and reoperation was performed,the patient did well 8 years after the reoperation. One patient with family CBT had an opposite lesion 10 years after the first lesion resection. Conclusions CBT may be bilateral,family occurrence,malignant changes and endocrine secretion charateristics. For small CBT, enucleation can be done first.If CA is involved, external CA remove along with CBT and end to end anastomosis may be a better choice . For tumors invading the internal CA, it is better to resect the lesion with reconstruction of the CA with, an autogenous internal jugular vein graft or prosthesis. For large CBT or CBT adhensed to nearby tissues seriously, end to end anastomosis can be carried out to internal CA at a transversely cutting surface of CBT.

Objective To investigate the efficacy of cavo-meso-atrial shunt for the treatment of Budd-Chiari syndrome (BCS) with occlusion of both inferior vena cava (IVC) and hepatic veins (HVs) lesions. Method 14 cases with BCS due to combined occlusion of IVC and HVs were treated from 1996. 8 cases were male and 6 cases female.The age ranged from 20 to 36 years old. HVs occlusion with complete IVC occlusion was found in 12 cases and stenosis of IVC in 2 cases. Cavo-meso-atrial shunt was performed. Result There was no perioperative death. Thrombosis of graft occurred in two cases, one died of upper digestive tract bleeding and hepatic coma half year post-operation. The mortality rate at follow-up period was 7%, the total patency of graft was 86% and the patency of cavo-atrial graft was 93%. The decrease in portal vein pressure was between 5 to 26 cmH 2O with an average of 15.5 cmH 2O. No serious complications occurred. Conclusion The cavo-meso-atrial graft shunt is an alternative to treat patients with occlusion of both IVC and HVs due to IVC thrombosis. The long term patency remains to be evaluated.

Objective To study the therapeutic effect of percutaneous transluminial angiography (PTA) and expandable metal stent (EMS) on the treatment of Budd Chiari syndrome(BCS). Methods One hundred and twenty patients with BCS confirmed by color Doppler ultrasonography, inferior vena cava venography and hepatic veins venography. All the 120 patients underwent PTA and EMS. All the 120 patients were followed up for 6 to 108 months. Results The treatment results in 115 patients(95.8%) were satisfactory,and 5 cases had recurrent during follow up . Conclusions PTA with EMS is an excellent method to treat the cases of BCS with non long segment occlusion of IVC.

[Summary] As the gradual deepening understanding of gastroesophageal reflux disease ( GERD ) , more extraesophageal symptoms are noted .The concept and therapeutic strategy for GERD has also undergone a quiet revolution over recent years .The application of proton pump inhibitor ( PPI) has been a landmark of medical treatment for GERD , and the invention of laparoscopic fundoplication and endoscopic radiofrequency energy delivery to the lower esophageal sphincter are marking a new era of comprehensive therapy for GERD .Good short and long term outcomes have been obtained since endoscopic radiofrequency energy delivery to the lower esophageal sphincter was applied on typical symptoms of GERD .Furthermore, the technique has also been successfully used in treating extraesophageal symptoms induced by proximal reflux in China .With more simple and less invasive features compared with anti-reflux surgery, the radiofrequency procedure has broad application prospects .

50%) rate of 11.6%.Conclusions Endovascular stent placement is a safe and effective procedure and may be selected as the first choice for severe subclavian arterial occlusion.Short-term follow-up shows a satisfactory clinical outcome.

ObjectiveTo prospectively evaluate the therapeutic effect of Alvenor on symptoms and signs of chronic venous insufficiency of lower extremities.MethodAccording to preset criteria, 133 patients from 8 hospitals in Hangzhou, Beijing, Guanzhou and Shanghai were recruited into this study including 78 males (58.6%) and 55 females (41.4%). The average age was 23～77 (55?13) years. The illness course was from 1～50 years with a mean of (11?11) yrs. Other therapeutic modalities were adopted in 34 before inclusion into this study and 38 cases (28.8% ) had suffered from certain complications. Classification was first defined when the patient was enrolled and clinical symptoms and signs were evaluated. Alvenor was given 500?mg, twice a day orally. Reevaluation and record by the same criteria was carried out 15, 30, and 60 days after treatment, and statistical analysis was conducted. ResultsSwelling, heaviness, spasm, and pain, etc, were statistically improved. ConclusionsAlvenor is effective in the treatment of symptoms and signs of chronic venous insufficiency of the lower extremities.

Objective Endovascular tubular stent grafting has emerged as an alternative therapeutic modality for patients with aortic dissections. However, its application has been limited to the descending thoracic aorta distal to the origin of the left subclavian artery. The initial clinical experience of endovascular branched stent graft repair for aortic arch dissections involving the left subclavian artery was reported. Methods From February 2004 to January 2005, the endovascular branched aortic stent-grafts made by Beijing YuHengJia SciTech Co. were applied in 42 patients with Stanford type B aortic dissection with the entry tears just beyond (

Objective To investigate the curative effect of endovascular treatment for inferior vena cava syndrome(IVCS).Methods A total of 17 cases of inferior vena cava syndrome was treated by endovascular dilatation and self-expandable metallic stent placement between June 2002 and November 2004.Routine anticoagulation therapy was given after the procedure.Results The pressure gradient across the inferior vena cava was reduced from 16.8?4.3 mmHg preoperatively to 2.6?0.6 mmHg postoperatively(t=13.280,P=0.001).The IVCS symptom scores were decreased from 4.4?1.6 preoperatively to 2.1?1.7 postoperatively(t=6.880,P=0.010).Symptoms of edema on lower limbs,scrotal or pubic dropsy,ascites,and anasarca subsided at 1～4 days after procedure.Conclusions Endovascular treatment of inferior vena cava syndrome is effective and reliable.